Osteoporosis International

, Volume 3, Issue 2, pp 59–65 | Cite as

Effects of age and menopause on bone density of entire skeleton in healthy and osteoporotic women

  • R. Nuti
  • G. Martini
Original Article


We studied 885 women to evaluate the effects of age and menopause on bone mineral density (BMD) in both healthy and postmenopausal osteoporotic subjects. The study cohort consisted of 161 healthy premenopausal women (age range 25–54 years), 357 healthy postmenopausal women (35–85 years) and 367 osteoporotic women (41–87 years). Total body and regional (spine, trunk, pelvis, arms, legs) BMD were measured with a dual-energy X-ray (DXA) device (Lunar DPX). Premenopausal BMD values remained essentially unchanged until the first half of the fourth decade, when they decreased. BMD values in both healthy postmenopausal and osteoporotic women were significantly lower than premenopausal values, and continued to decrease statistically after the onset of menopause. The highestZ-score (0.96±0.92) was found for total body BMD. HigherT-score values were found in osteoporotic than in normal postmenopausal women. In both healthy and osteoporotic postmenopausal women the best fits for BMD changes in total body, spine, trunk, arms and legs were obtained with the natural logarithm of years since menopause; only the pelvis BMD decreased linearly. Multiple regression analysis indicated that postmenopausal BMD changes in both normal and osteoporotic women were linked chiefly to body weight and years since the onset of menopause.


Age Bone density Menopause Premenopause Postmenopausal osteoporosis Total body absorptiometry 


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  1. 1.
    Hui LS, Slemenda WC, Johnston CC. Age and bone mass as predictors of fracture in a prospective study. J Clin Invest 1988;81:1804–9.Google Scholar
  2. 2.
    Thomsen K, Gottfredsen A, Christiansen C. Is postmenopausal bone loss an age-related phenomenon? Calcif Tissue Int 1986;39:123–7.Google Scholar
  3. 3.
    Nilas L, Christiansen C. Bone mass and its relationship to age and the menopause. J Clin Endocrinol Metab 1987;65:697–702.Google Scholar
  4. 4.
    Hansson TH, Roos BO, Nachemson A. The bone mineral content and ultimate compressive strength of lumbar vertebrae. Spine 1980;5:46–55.Google Scholar
  5. 5.
    Ericksson SA, Isberg BO, Lindgren JA. Prediction of vertebral strength by dual-photon absorptiometry and quantitative computed tomography. Calcif Tissue Int 1989;44:243–50.Google Scholar
  6. 6.
    Riggs BL, Melton LJ. Involutional osteoporosis. N Engl J Med 1986;314:1676–86.Google Scholar
  7. 7.
    Melton LJ, Whaner HW, Richelson LS, O'Fallon WM, Riggs BL. Osteoporosis and the risk of hip fracture. Am J Epidemiol 1986;124:254–61.Google Scholar
  8. 8.
    Cummings SR, Black DM, Nevitt MC et al. Appendicular bone density and age predict hip fracture in women. JAMA 1990;263:665–8.Google Scholar
  9. 9.
    Hansson T, Ross B. Age changes in the bone mineral of the lumbar spine in normal women. Calcif Tissue Int 1986;38:249–51.Google Scholar
  10. 10.
    Krolner B, Nielsen P. Bone mineral content of the lumbar spine in normal and osteoporotic women: cross sectional and longitudinal studies. Clin Sci 1982;62:329–36.Google Scholar
  11. 11.
    Aloia JF, Vaswani A, Ross P, Cohn SH. Aging bone loss from the femur, spine, radius and total skeleton. Metabolism 1990;39:1144–50.Google Scholar
  12. 12.
    Riggs BL, Wahner HW, Dunn WL, Mazess RB, Offord KB. Differential changes in bone mineral density of the appendicular and axial skeleton with aging. J Clin Invest 1981;67:326–35.Google Scholar
  13. 13.
    Davis JW, Ross PD, Wasnich RD, Maclean CJ, Vogel JM. Comparison of cross-sectional and longitudinal measurements of age-related changes in bone mineral content. J Bone Miner Res 1989;4:351–7.Google Scholar
  14. 14.
    Elders JMP, Netelenbos JC, Lips P, VanGinkel FC, Van Den Stelt PF. Accelerated vertebral bone loss in relation to the menopause: a cross sectional study on lumbar bone density in 286 women of 46 to 55 years of age. Bone Miner 1988;5:11–19.Google Scholar
  15. 15.
    Ribot C, Tremollieres F, Pouilles JM, Louvet JP, Guiraud R. Influence of the menopause and aging on spinal density in French women. Bone Miner 1988;5:89–97.Google Scholar
  16. 16.
    Schaadt O, Bohr H. Different trends of age-related diminution of bone mineral content in the lumbar spine, femoral neck, and femoral shaft in women. Calcif Tissue Int 1988;42:71–6.Google Scholar
  17. 17.
    Mazess RB, Collick B, Trempe J, Barden H, Hanson J. Performance evaluation of a dual-energy x-ray bone densitometer. Calcif Tissue Int 1989;44:228–32.Google Scholar
  18. 18.
    Nuti R, Martini G, Righi G, Frediani B, Turchetti V. Comparison of total body measurements by dual-energy x-ray absorptiometry and dual-photon absorptiometry. J Bone Miner Res 1991;6:681–7.Google Scholar
  19. 19.
    Le Blanc A, Schneider VS, Engelbretson DA, Evans HJ. Precision of regional bone measurements obtained from total body scans. J Nucl Med 1990;31:43–5.Google Scholar
  20. 20.
    Mazess RB, Barden HS. Bone densitometry for diagnosis and monitoring osteoporosis. Proc Soc Exp Biol Med 1989;151:261–71.Google Scholar
  21. 21.
    Mazess RB, Barden HS, Vetter J. Ettinger M. Advances in noninvasive bone measurements. Ann Biomed Eng 1989;17:177–181.Google Scholar
  22. 22.
    Duncan DB. Multiple range and multipleF tests. Biometrics 1955;11:1–42.Google Scholar
  23. 23.
    Trevisan C, Ortolani S, Bianchi ML et al. Age, time since menopause, and body parameters as determinants of female spinal bone mass: a mathematical model. Calcif Tissue Int 1991;49:1–5.Google Scholar
  24. 24.
    Gotfredsen A, Podenphant J, Nilas L, Christiansen C. Discriminative ability of total body bone mineral measured by dual photon absorptiometry. Scand J Clin Lab Invest 1989;49:125–34.Google Scholar
  25. 25.
    Rodin A, Murby B, Smith A, et al. Premenopausal bone loss in the lumbar spine and neck of femur: a study of 235 Caucasian women. Bone 1990;11:1–5.Google Scholar
  26. 26.
    Falch JA, Oftebro H, Haug E. Early postmenopausal bone loss is not associated with a decrease in circulating levels of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, or vitamin D-binding protein. J Clin Endocrinol Metab 1986;64:836–41.Google Scholar
  27. 27.
    Nilas L, Christiansen C. Rates of bone loss in normal women: evidence of accelerated trabecular bone loss after the menopause. Eur J Clin Invest 1988;18:529–34.Google Scholar
  28. 28.
    Gallagher JC, Goldgar D, Moy A. Total bone calcium in normal women: effect of age and menopause status. J Bone Miner Res 1987;2:491–6.Google Scholar
  29. 29.
    Nordin BEC, Need AG, Chatterton BE, Horowitz M, Morris HA. The relative contribution of age and years since menopause to postmenopausal bone loss. J Clin Endocrinol Metab 1990;70:83–8.Google Scholar
  30. 30.
    Gotfredsen A, Nilas L, Podenphant J, Hadberg A, Christiansen C. Regional bone mineral in healthy and osteoporotic women: a cross sectional study. Scand J Clin Lab Invest 1989;49:739–49.Google Scholar
  31. 31.
    Smith DM, Khairi MA, Johnston CC. The loss of bone mineral with aging and its relationship to risk of fracture. J Clin Invest 1975;56:311–18.Google Scholar
  32. 32.
    Duboeuf F, Braillou P, Chepuy MC, et al. Bone mineral density of the hip measured with dual-energy x-ray absorptiometry in normal elderly women and in patients with hip fracture. Osteoporosis Int 1991;1:242–9.Google Scholar

Copyright information

© European Foundation for Osteoporosis 1993

Authors and Affiliations

  • R. Nuti
    • 1
  • G. Martini
    • 1
  1. 1.Metabolic Bone Disease CentreUniversity of SienaSienaItaly

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